The Sebelius Record On Health Care

Top advisers to President Obama are telling the New York Times that Gov. Kathleen Sebelius (D-KS) — the former insurance commissioner and two term blue governor from a red state with a knack for bipartisanship — is Obama’s top choice to head the Department of Health and Human Services:

It remained unclear whether the White House would finish vetting Ms. Sebelius in time to nominate her by next week. Advisers described her as “the leading candidate,” although they said other names were still in discussion and emphasized that no final decision had been made.

While Sebelius certainly lacks Tom Daschle’s connections to Obama’s health team (and greater Washington), she is no stranger to the club. As a member of the National Governors Association’s executive committee, Sebelius led the health-care portion of the December 2 meeting with President Obama and Vice President Biden and has promoted the health care provisions in the stimulus. According to the AP, Sebelius has even budgeted “a small part of its federal stimulus money” to “add about 8,000 kids to the state’s Children’s Health Insurance Program.”

In fact, a review of Sebelius’ record suggests that she’s a practical proponent of Obama’s health principles, willing to pursue, promote and defend comprehensive reform, despite political opposition.


As Insurance Commissioner for Kansas from 1994 to 2002, Sebelius refused to accept contributions from the insurance industry and blocked a merger between Blue Cross Blue Shield of Kansas and Anthem, an Indiana insurer. The merger “drew opposition from many Kansas doctors, hospitals and nurses, as well as an advocacy group for poor and working-class families” and would have increased premiums “by $248 million over fiver years.” [Associated Press, 6/11/02] Sebelius, however, “turned the office of the Insurance Commissioner into an activist regulator, pursuing HMOs who denied care and pushing for cheaper prescription drugs for seniors.”

Sebelius continued to promote health care reform in the governor’s office, focusing primarily on cost containment. To improve efficiency, Sebelius ordered that all of the state’s major health care programs, including Medicaid, be “streamlined into a new business division called the Kansas Health Policy Authority” and launched the HealthyKansas initiative to promote prevention and wellness initiatives.

Moreover, the Governor’s Health Care Cost Containment Commission pursued many of the health care ideas incorporated into the stimulus. The commission included “representatives of the health care provider community, business community, health plans, legislators and other stakeholders in the health care community” and developed strategies to reduce unnecessary administrative costs and facilitate the adoption of a state-wide health information technology and exchange system.

The group explored ways to establish an “interoperable health information exchange,” created task-force to develop state-wide standards for health insurance ID cards, and formed a public-private partnership to plan and implement “a health information infrastructure capable of accurately and efficiently recording and tracking all aspects of health care delivery and payment.”

It wasn’t until January 2007, however, that Sebelius made a coordinated public push towards expanding health coverage for children under five. “We must commit ourselves to the goal that all Kansans will have health insurance and we must begin now,” Sebelius said during her State of the State address. “My budget takes an important step toward achieving that goal by making sure every young Kansas child has health coverage.”


While the effort ultimately failed, Sebelius’ decision to pursue expansion in the political jungles of Kansasian conservatism, suggests that the governor is more than capable (and willing) to fight the uphill battle for health reform. All in all, her ability to reach health policy decisions by soliciting the views of a broad spectrum of stakeholders suggests that she’ll be an important player in promoting Obama’s health reform agenda and a strong consensus builder.


Tim Foley, Ezra Klein, Jonathan Cohn, and WSJ Health Blog have more.